I'm a 60-year-old woman, overweight but mostly healthy. I take medication for moderate hypertension and for asthma. I have osteoarthritis like every other aging person in my family, but have had no medical treatment for it so far. I have an appointment scheduled for a few weeks at my HMO, but my experience is that they are reluctant to make referrals or do much about orthopedic stuff.

The current problem probably started when I injured my left hip in a fall four years ago. The pain from this was severe at the time, but it was never X-rayed or treated in any way. It got better, but since then has always been stiff and sore--ever since then I take stairs one at a time, for instance. In the past few months, it has become extremely painful, bad enough so that sleeping has become a big problem. The hip and lower back hurt, but the most severe pain is charley-horse type cramps down the outside of my left leg, down to the ankle, and recurrent cramping pain very deep in my groin. I have been talking to a co-worker who recently had a hip replacement after similar problems. My questions--a) is it likely that all the pain involved originates with the hip problem, or should I be concerned about something else going on in my abdomen? b) what are the various possible approaches to the problem if it *is* just the hip having lost all its cartiledge? I hate the idea of surgery, and I'll bet anything I will have to fight the HMO for it. At the same time, I'm still working full time (as a teacher) and have no plans to retire soon, and this pain situation is getting impossible. (My current regime is just soaking in the tub and taking a lot of aspirin, which seems to help as much as anything.)

Hello,
I understand your frustration, especially if you have difficulty getting referrals. This is one I would suggest you fight for because you could likely benefit from either an orthopedic doctor or a rheumatologist. The latter would be most helpful if this is osteoarthritis or something of that nature. It certainly sounds suspicious for that and often it settles in places of past injury.

This is not to say it couldn't be something else - it could even originate in your back, but either way, you need to have this examined by a doctor. There are effective treatments but of course you need to be sure you have the proper diagnosis first.